Gasco J, Franklin B, Fuller G N, Salinas P, Prabhu S
Division of Neurosurgery, The University of Texas Medical Branch, Galveston, Texas 77555-0517, USA.
Neurocirugia (Astur). 2009 Dec;20(6):550-4. doi: 10.1016/s1130-1473(09)70133-2.
Epithelioid glioblastoma is a rare morphologic subtype of glioblastoma that closely mimics metastatic carcinoma or metastatic melanoma histologically. All previous case reports of this unusual glioblastoma variant have been solitary lesions. We report here the first case to our knowledge of multifocal epithelioid glioblastoma mimicking cerebral metastasis.
A 67-year-old man with a prior history of mycosis fungoides, a common form of cutaneous T-cell lymphoma, presented with memory loss and impaired peripheral vision. Two discrete brain lesions highly suspicious for metastases were identified by magnetic resonance imaging (MRI).
The patient underwent two separate craniotomies; both lesions were successfully resected in toto with an excellent post-surgical outcome.
Epithelioid glioblastoma is one of the rarest morphologic subtypes of glioblastoma. Here we describe the first case to our knowledge of multifocal epithelioid glioblastoma that convincingly mimicked a secondary metastatic process. Multifocal epithelioid glioblastoma should be included in the differential diagnosis of patients who present with multiple discrete brain lesions. An attempt at gross total resection is recommended when anatomically feasible for definitive histopathological diagnosis and to improve progression free survival of patients who present with similarly ambiguous and potentially misleading multiple lesions.
上皮样胶质母细胞瘤是胶质母细胞瘤一种罕见的形态学亚型，在组织学上与转移性癌或转移性黑色素瘤极为相似。此前关于这种不寻常的胶质母细胞瘤变体的所有病例报告均为孤立性病变。据我们所知，本文报告了首例多灶性上皮样胶质母细胞瘤，其表现类似脑转移瘤。
一名67岁男性，既往有蕈样肉芽肿病史，这是一种常见的皮肤T细胞淋巴瘤，此次因记忆力减退和周边视力受损就诊。磁共振成像（MRI）检查发现两个高度可疑为转移瘤的离散性脑病变。
患者接受了两次单独的开颅手术；两个病变均成功完整切除，术后效果良好。
上皮样胶质母细胞瘤是胶质母细胞瘤最罕见的形态学亚型之一。据我们所知，本文描述了首例多灶性上皮样胶质母细胞瘤，其令人信服地模拟了继发性转移过程。对于出现多个离散性脑病变的患者，鉴别诊断应包括多灶性上皮样胶质母细胞瘤。在解剖学可行的情况下，建议尝试进行全切除，以获得明确的组织病理学诊断，并改善出现类似模糊且可能具有误导性的多个病变患者的无进展生存期。
